A Swedish sociologist Lars Tornstam describes this by asking what a 10 year old would say if we asked him what it would be like to be 20. It would be awful to him. There would be no play time. There would be no summer vacation. He would have to get a job! But at twenty he would look back at the age of 10 and say: “There’s no way ...

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The art and practice of medicine is built around lessening the suffering of our fellow man. The method of doing this however, has changed dramatically throughout human history. Western medicine had its beginnings in the restoring balance to the body that was not in sync with the environment. As scientific reasoning found its way into medical practice after the dark ages, the benefits of medicine quickly became a cornerstone of ...

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We’ve all seen the data projecting a shortage of physicians in the United States, expected to reach a shortfall of more than 90,000 by 2020. The lack of nurses is equally well documented. These trends raise concern for all medical specialties, but especially for primary care. More and more Americans are expected to need these services in the coming years, at a time when fewer and fewer students are committing to ...

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“Value” is the pot of gold at the end of the rainbow that health care professionals everywhere are seeking, but which few can seem to find. Policy makers, hospital executives, physicians,  consultants – all are looking for a means to pivot away from a system that rewards volume of services provided to one that rewards quality and cost effectiveness (i.e., “value”). How far we are from achieving this goal can be gauged ...

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I work at several hospitals and each uses a different electronic medical record system. When I switch from hospital one to another, I obviously have my favorite EMR systems and my not so favorite EMR systems. In the previous post, I was using the EMPOWER charting system, which I liked for its simplicity, but disliked because of the layouts of the charting interface and some of the macros ...

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Cancer makes you realize the gift of timeWhen I was 16 my dad had a heart attack. I still recall studying in my room when my mom came in to tell me he wasn’t feeling well. At the time, I was a volunteer in the emergency room at our local hospital, located in the tiny Pacific Island of Guam. I recall asking him what he was experiencing: ...

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The state legislature in Florida decided it is legal and appropriate for pharmacists and pharmacies to begin administering vaccines against multiple diseases.  Their list of adult vaccines includes seasonal flu shots, Pneumovax (pneumonia vaccine) and Zostavax (vaccine to prevent shingles).  The rationale of the legislature is that access to doctors to receive these preventive vaccines is limited and difficult. By refusing to administer vaccines in their office because it is time ...

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The other night, a patient gave me a piece of his mind. Mr. Q was a middle-aged man debilitated by days of nausea, vomiting and intractable belly pain. That morning, his wife finally convinced him to get medical attention and drove him to our emergency department. On arrival, he sat in a cubicle in the waiting room and explained his story to a triage doctor: how he was doing well ...

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“This note was produced using [mega-brand] medical dictation software. While every effort has been made to insure accuracy, errors may still exist.” Really? What kind of doctor would admit in a medical chart to being too lazy or incompetent to produce an accurate record? A lot of them.  Dictations are easy to read if you are willing to confound legibility and accuracy.  Dictation software is relatively cheap, and with the continued profusion ...

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Millions of Americans believe in the practice. Government reformers believe in it. Doctors too. Heck, even I, an accused therapeutic nihilist, tracked down a poor soul who agreed to be my primary care doctor. Call it old-fashioned, but I wanted my own doc, and I wanted yearly “checkups.” No procedure—not even AF ablation–is as good as prevention. Taking your body in for routine checks and scheduled maintenance makes perfect sense. Call such a notion–obvious. But ...

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